The present invention relates to an anoscope for surgical use or to be used as a probe.
Anoscopes are instruments specifically constructed to allow medical operators to view the region of the anal orifice and the initial tract of the rectum, by dilating the anal opening. They have long been used in the medical field to examine the anorectal region.
These instruments are formed as cylindrical bodies or retractor flaps.
In the first instance, such cylindrical bodies have diameters calibrated for insertion in the anal canal and are internally provided with a cavity with an open bottom end; insertion is made possible by using appropriately provided cylindrical insertion instruments, which have a rounded end and are removed once the operation has been completed, to leave the cylindrical bodies in place in order to allow the operator to view the exposed regions, onto which light is shed by a light source (lamp or optical fiber) which is also provided. The source is integrated in a handle for manoeuvering the cylindrical body, which is arranged at the end directed toward the operator.
In so far as the present description is concerned, the end directed towards the operator is called xe2x80x9cproximal endxe2x80x9d, and the opposite end is called xe2x80x9cdistal endxe2x80x9d.
In the second case, the flaps of the retractors (known as Eisenhammer""s, Ferrand""s, Park""s retractors) are rounded in shape, so as to define a sort of ogive in a clustered closing configuration, in order to facilitate insertion through the anal orifice, and they are provided with means for locking the flaps in a divaricated position when they are operatively arranged inside the rectum.
No light source is provided in this type of anoscope.
In the first instance all inspection or surgery is carried out through the longitudinal opening, whereas in the second instance it is made possible through the divaricated flaps.
Both the above described types of anoscope suffer from some drawbacks which make them substantially cumbersome to use and in some cases painful and even dangerous for the patient.
For cylindrical anoscopes, the main problems are the confined viewing and operating field and the unsteady illumination of the region to be viewed that can be achieved.
In the second case, control of the retractors is an extremely delicate procedure that relies on the tactile sensitivity of the medical operator, since no means suitable for limiting their opening is provided on such retractors; if the patient has a muscle configuration which is particularly resistant to divarication, or if the operator proceeds with excessive force, the patient may in fact suffer painful traumas, which sometimes damage the integrity of the sphincter muscles, with the typical ensuing consequences associated with it.
Moreover, once the flaps of the retractors are positioned and divaricated to allow operation, they partially or even fully reduce the visual-operating field formed between the flaps.
This is due to the natural collapse that the rectal mucous membrane is subject to.
Moreover, the flaps of the retractors are usually made of durable material which can be accordingly reused on several patients, albeit every time after appropriate sterilization; if this sterilization is not performed properly, it entails the risk of promoting transmission of germs among different patients.
The object of the present invention is to solve the above described problems of the prior art, by providing a anoscope for surgery or inspection, which is sterile and disposable, that allows a precise viewing of better illuminated stretches of the field of view for inspection or surgery, with respect to what has been hitherto possible in the devices of the state of the art; that is automatic, i.e. not needing auxiliary tools, atraumatic in every respect, and allowing medical operators to carry out surgery and inspection with better comfort, in comparison with the conventional anoscopes currently used.
This aim and these and other objects which will become better apparent hereinafter are accomplished by a anoscope for surgery and inspection, comprising:
a tubular body having a distal blind end and a proximal open end;
an inner light reflecting surface located at said distal blind end;
at least one slot formed in said tubular body;
a light source placed in light reflection relationship with said inner reflecting surface; and
a maneouvering handle arranged to act on said proximal end of said tubular body.